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Found 16054 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:608825 (history)  Vaccinated:2015-11-05
Age:71.0  Onset:2015-11-05, Days after vaccination: 0
Gender:Female  Submitted:2015-11-10, Days after onset: 5
Location:New York  Entered:2015-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hives~Tdap (Boostrix)~UN~64.00~Patient
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: Diet controlled DM
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM16258 UNRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Injection site erythema, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 11/05 Adm 6pm, in 2hrs fever, headache, redness at site lack of energy, local urticaria extending down right arm.

VAERS ID:608827 (history)  Vaccinated:2015-11-04
Age:0.6  Onset:0000-00-00
Gender:Female  Submitted:2015-11-09
Location:California  Entered:2015-11-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS39TA32IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5344AA0UNRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.L0144292IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992592IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.L0080312PO 
Administered by: Public     Purchased by: Public
Symptoms: Dyskinesia, Injection site abscess, Injection site cellulitis, Seizure, Tic
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Convulsions - tics - jerking non purposeful movements. (L) leg cellulitis/abscess.

VAERS ID:608873 (history)  Vaccinated:2015-11-02
Age:1.0  Onset:2015-11-09, Days after vaccination: 7
Gender:Female  Submitted:2015-11-10, Days after onset: 1
Location:Louisiana  Entered:2015-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0028160SCRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ168833IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0077810SCLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Vaccinated on 11/2/15 - on 11/9/15 - mother noticed site of varicella to be dark red, warm to touch measuring - 3/4 inch by 5/8 inch (L) lateral thigh - child very playful and no temperature.

VAERS ID:608247 (history)  Vaccinated:2015-09-23
Age:5.0  Onset:0000-00-00
Gender:Male  Submitted:2015-11-09
Location:Unknown  Entered:2015-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1511USA003876
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNAR
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a physician and from a nurse via a company representative refers to a 5 year old male patient. There were no concomitant medications, concurrent conditions and medical history reported. On 23-SEP-2015, the patient was vaccinated with PREVNAR (route of administration, dose, lot# and expiration date were not reported). On 23-OCT-2015, the patient was vaccinated with one dose of PNEUMOVAX 23 lot # K020215 (route of administration and expiration date were not reported). On an unknown date in October 2015, after receiving PNEUMOVAX 23, the patient''s whole arm was red, swollen, and painful. On an unknown date in October 2015, the patient was admitted to a hospital for an unspecified length of time. The physician reported that after 48 hours after being given the vaccine, the child began to normalize. The patient was treated with BENADRYL. The outcome of the events was reported as recovered/resolved on an unknown date in 2015. The relatedness between the events and PNEUMOVAX 23 was not reported. Additional information has been requested.

VAERS ID:608267 (history)  Vaccinated:2015-10-29
Age:0.4  Onset:2015-11-03, Days after vaccination: 5
Gender:Male  Submitted:2015-11-09, Days after onset: 6
Location:Michigan  Entered:2015-11-09
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: Patient needed surgical correction of intussusception and PICU admission.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS39LA31IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.L0128381IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL871171IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0247001PO 
Administered by: Private     Purchased by: Private
Symptoms: Intensive care, Intussusception, Irritability, Melaena, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: Vomiting and Melena. Persistent irritability.

VAERS ID:608304 (history)  Vaccinated:2015-11-04
Age:56.0  Onset:2015-11-05, Days after vaccination: 1
Gender:Female  Submitted:2015-11-09, Days after onset: 4
Location:Missouri  Entered:2015-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: RA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM068990IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm at injection became sore and tender. Noticed four red areas around injection sight. Warm to touch. Patient applied ice packs and OTC ointment per self. Symptoms improved.

VAERS ID:608343 (history)  Vaccinated:2015-10-26
Age:  Onset:2015-10-26, Days after vaccination: 0
Gender:Male  Submitted:2015-11-04, Days after onset: 9
Location:Unknown  Entered:2015-11-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015375107
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL625074 SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: This is a spontaneous report from a contactable pharmacist, who reported the same event for 2 patients. This is the second of two reports. A male patient of unspecified age and ethnicity received a single dose of PREVNAR 13 (Lot L625074, Expiry date 30Nov2016) in the arm on 26Oct2015. Medical history and concomitant medications were not reported. The patient had a cellulitis type of reaction on the same day. The outcome of the event was unknown. The pharmacist believed that the cellulitis occurred after having shot of PREVNAR 13 as it was at same arm as the injection site.

VAERS ID:608346 (history)  Vaccinated:0000-00-00
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2015-11-06
Location:Unknown  Entered:2015-11-09, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015364817
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Cerebrovascular accident, Disability
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)
Write-up: This is a spontaneous report from a contactable consumer who reported for a patient. A patient of an unspecified age, ethnicity and gender received PREVNAR 13, via an unspecified route of administration on an unspecified date at 0.5 ml single. Medical history and concomitant medications were not reported. The consumer reported that someone she knew complained of stroked out and become disabled after the injection on an unspecified date. The outcome of the event was unknown.

VAERS ID:608347 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2015-11-05
Location:Unknown  Entered:2015-11-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions: Myelodysplastic syndrome; Immunosuppression; Transfusion, every 6-8 weeks
Diagnostic Lab Data: Haemoglobin, 6.9; Haemoglobin, 8.7
CDC Split Type: 2015357971
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNAR
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNAR
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Feeling abnormal, Haemoglobin decreased, Malaise, Transfusion
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Dementia (broad)
Write-up: This is a spontaneous report from a contactable nurse (the patient). A 25 year-old female patient of unspecified ethnicity received PREVNAR 13 at a single dose and flu vaccine (manufacturer unknown) at an unknown dose both via an unspecified route of administration on arm, on an unspecified date in 2015. Relevant medical history included myelodysplastic syndrome and she was immunosuppressed both ongoing. Somewhere the patient had received transfusion every 6-8 weeks. Concomitant medications were not reported. The day after the vaccination in 2015, the patient did not feel well, she felt terrible and sick. She had extreme exhaustion to the point where she could barely put one foot in front of the other. The patient underwent blood work and the hemoglobin went from 8.7 to 6.9 (unit unspecified) and she was transfused. The outcome of the events was unknown. Causality was not available.

VAERS ID:608349 (history)  Vaccinated:2015-04-02
Age:74.0  Onset:0000-00-00
Gender:Female  Submitted:2015-11-05
Location:Kansas  Entered:2015-11-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Potassium; Metformin; Losartan; Aspirin; CRESTOR; Hydrochlorothiazide; Vitamin D
Current Illness: Unknown
Preexisting Conditions: Hypertension; Hyperlipidaemia; Diabetes mellitus, mild; Vitamin D deficiency; Pneumococcal vaccine, Immunisation
Diagnostic Lab Data:
CDC Split Type: 2015191019
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ20347 SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Discomfort, Hypoaesthesia, Injection site hypersensitivity, Mobility decreased, Pain, Pain in extremity, Paraesthesia, Pseudoparalysis
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: This is a spontaneous report from a consumer (medical assistant), from a contactable other HCP (healthcare professional), from a contactable physician and from a contactable consumer reporting for herself. A 74-year-old female patient of an unspecified ethnicity received PREVNAR 13 (Lot number J20347, Expiration date Jun2016, NDC number 0005197101) on 02Apr2015 at 0.5 ml single in the right deltoid. Relevant medical history included high blood pressure, hyperlipidemia, mild diabetes, and vitamin D deficiency. The patient received in the past an unspecified pneumococcal vaccine. Concomitant medications included ongoing potassium, ongoing metformin, ongoing losartan, ongoing Aspirin, CRESTOR, ongoing hydrochlorothiazide, and ongoing Vitamin D. On an unspecified date in 2015, the patient had an allergic reaction due to PREVNAR 13 injection. The patient stated that the event was in the arm where the vaccine was administered. The medical assistant mentioned that patient did not receive any treatment in response to the event and no laboratory tests were performed. Also the patient developed side effects from the vaccination, such as numbness, tingling and discomfort on unknown date in 2015. Additionally, the patient added that she was having so much pain and her arm was practically paralyzed on unknown date in 2015. Treatment of pain included unspecified pills. All the events were not recovered and she is having so much pain in 2 fingers at night. According to the consumer she was hospitalized for the events allergic reaction in arm where the vaccine was administered, numbness, having so much pain, discomfort and tingling. The other HCP, on behalf of the physician, reported that the patient did not require hospitalization in response to the event, and also considered that the vaccine had a causal effect to the adverse event. Follow-up (13Jul2015): New information received other HCP on behalf of a physician: includes: clinical course, reporter''s comment on causality assessment. Follow-up (09Sep2015): New information obtained from a contactable physician includes: additional events (numbness, tingling and discomfort). Follow-up attempts completed. No further information expected. Follow up (14Oct2015): New information received from a contactable consumer reporting for herself includes: additional events (having so much pain and her arm was practically paralyzed), treatment, past vaccine history and outcome. Follow up (02Nov2015): New information received from a contactable consumer reporting for herself includes: details on concomitant medications, outcome and seriousness criteria for the events. Follow-up attempts completed. No further information expected.

VAERS ID:608350 (history)  Vaccinated:2015-10-07
Age:  Onset:2015-10-07, Days after vaccination: 0
Gender:Unknown  Submitted:2015-11-04, Days after onset: 28
Location:Unknown  Entered:2015-11-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015375170
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL99271 SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: This is a spontaneous report from a contactable pharmacist, who reported the same event for 2 patients. This is the second of two reports. A patient of unspecified age, ethnicity and gender received a single dose of PREVNAR 13 (Lot L99271, Expiry date 31Mar2017) in the arm on 07Oct2015. Medical history and concomitant medications were not reported. The patient had a cellulitis type of reaction on the same day. The outcome of the event was unknown. The pharmacist believed that the cellulitis occurred after having shot of PREVNAR 13 as it was at same arm as the injection site.

VAERS ID:608356 (history)  Vaccinated:2015-10-27
Age:60.0  Onset:0000-00-00
Gender:Male  Submitted:2015-11-08
Location:Nevada  Entered:2015-11-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None listed
Preexisting Conditions: COPD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IMAR
Administered by: Unknown     Purchased by: Private
Symptoms: Mobility decreased
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt. states that after 1 wk, the arm is immobile - tx not known - instructed to call MD.

VAERS ID:608370 (history)  Vaccinated:2015-09-08
Age:1.0  Onset:2015-09-08, Days after vaccination: 0
Gender:Female  Submitted:2015-11-09, Days after onset: 62
Location:Florida  Entered:2015-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4838AA2IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0248251SCRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL601021IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0191251SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mother noticed a lump to right and left arms at vaccine site after infant received vaccines on 9/8/15. Mother stated she took the child to a General Doctor last week and that she was told the lumps would soon go away. Mother was concerned that the lump on left arm had gotten bigger. Referred client to pediatrician for evaluation and clearance for other vaccines.

VAERS ID:608386 (history)  Vaccinated:2015-09-11
Age:81.0  Onset:2015-09-15, Days after vaccination: 4
Gender:Female  Submitted:2015-09-30, Days after onset: 15
Location:New Mexico  Entered:2015-11-09, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Swollen red arm that traveled to elbow
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: None stated.

VAERS ID:608403 (history)  Vaccinated:2015-10-25
Age:78.0  Onset:2015-10-31, Days after vaccination: 6
Gender:Female  Submitted:2015-10-31, Days after onset: 0
Location:North Carolina  Entered:2015-11-09, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol; CLARITIN
Current Illness: No
Preexisting Conditions: Tachycardia; Allergic to IVP dye; Penicillin; Tetracycline
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI513AA SYRLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM08990SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Patient received a Flu shot FLUZONE HD and a PREVNAR-13 shot on 10-25-15. Both shots were administered in the left arm due to physical therapy/soreness in the right arm. Patient has had no reaction in the past to Flu shots. She stated that when she awoke today (10/31/15) her arm was bright red and very itchy. She came to the pharmacy to show me and she had a large erythematous area where the shots were given about 5 inches by 2.5 inches oval with warmth. Advised BENADRYL at bedtime.

VAERS ID:608405 (history)  Vaccinated:2015-10-23
Age:80.0  Onset:2015-10-24, Days after vaccination: 1
Gender:Male  Submitted:2015-11-02, Days after onset: 9
Location:Missouri  Entered:2015-11-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM068990IMUN
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Severe body aches starting day after getting PREVNAR 13 and lasting until given Rx of Prednisone on 10/28/15.

VAERS ID:608422 (history)  Vaccinated:2015-11-05
Age:1.6  Onset:0000-00-00
Gender:Female  Submitted:2015-11-09
Location:Texas  Entered:2015-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSFA5451IMRL
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSH33J22IMRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS7XB32 IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL77777 IMRL
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:608434 (history)  Vaccinated:2015-10-28
Age:68.0  Onset:2015-10-28, Days after vaccination: 0
Gender:Female  Submitted:2015-10-28, Days after onset: 0
Location:Wisconsin  Entered:2015-11-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan; Levothyroxine; PROAIR Inhaler
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI489AA IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM069000IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pruritus, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Mild itching at Flushot site; swelling in lips, went to physician, given steroid and antihistamines. Now symptoms are gone.

VAERS ID:608438 (history)  Vaccinated:2015-11-06
Age:79.0  Onset:2015-11-08, Days after vaccination: 2
Gender:Female  Submitted:2015-11-09, Days after onset: 1
Location:Wisconsin  Entered:2015-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC Naproxen - 2 tabs daily; Baby ASA 81mg daily; Pantoprazole 40mg daily; Sertraline 100mg daily; Levothyroxine 100mcg daily
Current Illness: No Illness.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM13607 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Pt called pharmacy on 11/8/15 to report bruising around injection site. Bruising started 3 inches down from left shoulder bone and is 2 inches in diameter. Pt reports taking NSAIDs and aspirin daily.

VAERS ID:608445 (history)  Vaccinated:2015-10-13
Age:76.0  Onset:2015-10-13, Days after vaccination: 0
Gender:Female  Submitted:2015-11-02, Days after onset: 20
Location:Kentucky  Entered:2015-11-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI437AA0IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992750IMRA
Administered by: Other     Purchased by: Public
Symptoms: Bursitis, Influenza like illness, Joint swelling, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient went to provider with swelling and pain in her shoulder, and flu-like symptoms. Provider diagnosed her with bursitis.

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